Prevalence of Inadvertent Perioperative Hypothermia and Associated Factors: A Cross-Sectional Study

Abstract

Inadvertent perioperative hypothermia, defined as a body temperature <36.0°C, is a common outcome of anesthesia that can cause serious consequences to patients. The aim of this study is to determine the prevalence of inadvertent hypothermia among surgical procedures from two referral centers in Brazil and to identify sociodemographic, clinical, or surgery-related predictors of hypothermia. This is a cross-sectional study, conducted at two public hospitals in Brasília, Brazil. After the exclusion of 109 patients, 312 subjects (American Society of Anesthesiologists [ASA] physical status I-III) were enrolled from July 2016 through July 2018. The main outcome measures were the prevalence of hypothermia and its predictors. The mean age of the 312 patients was 43.2 (18.2) years (range 18-85 years), and 186 (59.6%) were female. The prevalence of inadvertent hypothermia was 56.7%. Predictors of hypothermia were perioperative chills ( p = 0.026), patient's body temperature on arrival in the operating room ( p < 0.001), diabetes ( p < 0.001), ASA status III ( p < 0.001), systolic blood pressure ( p < 0.001), general anesthesia ( p < 0.001), medical specialty ( p < 0.001), fentanyl-based anesthesia ( p = 0.002), and surgery time ( p < 0.001). The multivariable model prediction model for hypothermia showed fairly good discrimination (area under the receiver operating characteristic: 79.0%, 95% confidence interval 68.0 to 80.1). Approximately 6 in 10 patients undergoing surgery developed inadvertent perioperative hypothermia. The risk of hypothermia is influenced by a myriad of factors that can be used in simple and low-cost predictive models with adequate discriminatory power.

Validation of a Prediction Model for Intraoperative Hypothermia in Patients Receiving General Anesthesia

“…Though international standards [ 1 , 10 ] have highlighted the importance of assessing for hypothermia risk in order to plan for perioperative thermal care, few clinical models have attempted to predict perioperative temperature by far [ 16 , 26 , 27 ], and validation of these rules has been limited [ 16 , 26 , 27 ]. Clinical guidelines [ 1 , 28 ] have also long established that all surgical patients should be maintaining normothermia via routine temperature measurement and active warming; however, compliance with the guidelines remains poor [ 11 – 13 ], even in developed Western countries, possibly due to unawareness of temperature management [ 12 , 13 , 29 ] and restricted healthcare resources [ 12 , 29 ].…”

Impact of the Hormonal Status in Women on Intraoperative Hypothermia during Laparoscopic Gynecologic Surgery when Considering the Fresh Gas Flow Rate: A Retrospective Study

“…Intraoperative hypothermia is defined as a core body temperature of less than 36°C in patients undergoing anesthesia and surgery [ 1 – 6 ]. An incidence of the condition has been reported between 20% and 90%, depending on the surgical and the demographic factors of the patient [ 2 , 3 ]. The adverse effects and complications of intraoperative hypothermia include cardiac arrhythmia, wound infection, postoperative pain, shivering, metabolic disturbances, and prolonged hospitalization [ 1 – 6 ].…”

Effects of Female Reproductive Hormone Levels on Inadvertent Intraoperative Hypothermia during Laparoscopic Gynecologic Surgery: A Retrospective Study

“…The incidence of inadvertent intraoperative hypothermia is reported to be between 20% and 90%, depending on the surgical population and demographic characteristics of the patients [1,2]. Inadvertent intraoperative hypothermia is defined as a core body temperature of <36 • C in patients undergoing surgery under general anesthesia [1][2][3][4][5][6].…”

“…The incidence of inadvertent intraoperative hypothermia is reported to be between 20% and 90%, depending on the surgical population and demographic characteristics of the patients [1,2]. Inadvertent intraoperative hypothermia is defined as a core body temperature of <36 • C in patients undergoing surgery under general anesthesia [1][2][3][4][5][6]. The consequences of intraoperative hypothermia include increased incidence of postoperative adverse events, such as surgical-site infection, pain, and prolonged recovery and hospitalization [1][2][3][4][5][6].…”

“…Inadvertent intraoperative hypothermia is defined as a core body temperature of <36 • C in patients undergoing surgery under general anesthesia [1][2][3][4][5][6]. The consequences of intraoperative hypothermia include increased incidence of postoperative adverse events, such as surgical-site infection, pain, and prolonged recovery and hospitalization [1][2][3][4][5][6].…”